Individual
ANTHONY DESTEFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 CARRIAGE PATH, MANORVILLE, NY 11949-2611
(631) 878-8304
(631) 878-8304
Mailing address
3 CARRIAGE PATH, MANORVILLE, NY 11949-2611
(516) 443-9877
(718) 777-5250
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001964-1
NY
103TS0200X
School Psychologist
Primary
—
NY
Other
Enumeration date
03/05/2007
Last updated
04/04/2008
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